A Christian View of Being a Physician

How should I love others? A doctor’s story.

by Nathan C. King, MD

While this meditation is from the context of being a doctor it is predominantly about being a Christian in this world, about answering the call to be a light in darkness, to be salt in a spoiling world. One of the most important questions a Christian will have to answer to God will be how they loved even “the least of these” (Matt 25:40).

The scriptural account of the command to love others is such a Godly act it is humanly impossible. When Jesus was asked how to inherit eternal life, Jesus explained the necessity of loving God and loving your neighbor then defined loving your neighbor in terms of the good Samaritan (Luke 25-37); at the last supper, just prior to being crucified for our sake and the sake of the disciples, Jesus instructs his disciples to love one another just as Jesus had loved them (John 13:34-35); and in the Sermon on the Mount, Jesus exhorts us all to love our enemies and pray for those who persecute us, “so that you may be sons of your Father who is in heaven” (Matthew 5:45). Love like this is unnatural, and God never intended for you to love others like this on your own strength.

I have been crucified with Christ. It is no longer I who live, but Christ who lives in me. And the life I now live in the flesh I live by faith in the Son of God, who loved me and gave himself for me. – Galatians 2:20

This supernatural love is given to us as an overflow of our faith in Christ and a recognition of His sacrifice.

When I started residency in July of 2013, I didn’t understand how hard it would be to love the people that would be under my care. At first I didn’t trust the worldly wisdom of peers (co-residents) and instructors (attendings), sensing the call to see sinners saved and lives transformed by the power of Christ. I knew that this metamorphosis had happened to me, and at first I really leaned into the wisdom that could be gleaned from my own redemption story.

I had been assigned to care for a very sick man who was drug addicted and homeless. As a result of IV drug abuse, bacteria had gotten into his blood and infected and destroyed two of his heart valves and as a result he had a terrible infection and his heart was failing. The bacteria were so deeply seeded that antibiotics would not be enough. He required a major heart surgery that involved replacement of at least one of his heart valves. Right away the surgeon refused to do the surgery, because the heart valve would require the patient to go on anticoagulation (blood thinning medication taken every day) for the rest of the patient’s life. There were resources in place so that we could assure that he had housing, medication, and even medical follow up; but the surgeon just didn’t trust the patient to follow through with any of it. At this time in the united states surgical outcomes for major heart surgery like this were publicly tracked and if the patient died it would show as a failed surgery and the surgeon would be less trusted to do future surgeries.

My heart broke for my patient as I explained this to him. The man in the bed pleaded with me for his life, so I agreed to help. Despite discouragement from my senior resident and my attending (the two doctors who supervised my work) I asked for a hospital ethics committee meeting with the surgeon. I stood by my patient’s bed while he dictated a letter. On the appointed day, I read the letter aloud at the ethics committee meeting, his voice through mine pleading for a second chance at life. The surgeon agreed to operate despite the high risk of a bad outcome.

There were several days prior to the scheduled surgery. On the first day my patient asked me why I was working so hard to help him, and to this point he hadn’t thanked me or acknowledged what a sacrifice I was making for him. Caught by surprise, I first asked if he really wanted to know, after he insisted, I explained that Jesus had been merciful to me when I didn’t deserve it, and that Christ had died for me and saved me, and that because Jesus had done that I knew I was supposed to go and do the same. He responded with tears and a reference to an old cowboy church that he had been a part of in the past. He even let me pray with him.

As the next days passed things got very strange. At first my patient let me pray with him each day during our visits. Then he told me he had spoken on the phone to a friend of his “in the government” who had told him not to trust me. I checked with his nurse who insisted he hadn’t been on the phone at all. He no longer let me pray with him. I arrived at the hospital on the morning of the scheduled surgery, and one of my co-residents told me that during the previous evening (just after I had left the hospital) my patient had somehow stood from his bed, torn out his IVs shouting and cursing as he hobbled out of the hospital leaving against medical advice. There would be no surgery.

The very next day, my patient was returned to the hospital ER by ambulance. He was found in an alley behind a fast-food restaurant less than a mile from our hospital. He tested positive for amphetamines. He was so weak from the returning force of his infection, not only could he not stand, he barely had enough strength in his voice to give one word responses. His illness really took over at that point. He rapidly became more ill each day and death came quickly. He never spoke to me again. My attending and senior resident forgave me for making them look foolish by explaining to me that I would soon grow out of my naive optimism.

At first I resisted. I told myself that I had been helping this man while leaning into the Gospel and trusting in God’s power as I experienced it redeeming me. But while watching him die, I became confused. I began to believe that I was supposed to see some measurable success. That this man should have had his surgery, repented of his sin, or at least survived to further consider whether or not he would receive God’s free gift of grace. I felt crushed under the weight of disappointment and failure. I didn’t yet understand that the call of the gospel is not to be measurably successful, but to be consistently faithful. As a result I grew discouraged in my efforts to share the gospel, self-reliant in my efforts to do my work, jaded in my efforts to fight for the good of my patients. I did not understand how to let the supernatural power of Christ’s love come through me.

In the months that followed those around me didn’t immediately notice the shift. My attending even told me that she relied on my “moral compass” when it came to issues of mercy or restraint. However, within a year, one of my co-residents (an atheist) was so shocked at my behavior, dismayed by my strangled restraint on mercy and strict adherence to self-protection, told me, “Nathan, you’ve really changed! You’re so jaded.” I felt only the slightest pang of conscious in my calloused heart and weary soul. I tried again for a few days to love others, but it just hurt too much. I was simply not strong enough. I quickly returned to my self protective stance of restrained giving and scarcely loving. I reassured myself that I was just doing as much as was sustainable, possible, and still pushing myself to my limits. I was a powerless Christian.

I’m sure that this is exactly the kind of powerlessness that Jesus disciples felt on the eve of the Crucifixion. Jesus gets arrested and they start to stir up what little strength they had on their own. Most of the disciples scatter, one even running away naked (Mark 14:52), but Peter resists, drawing his sword and cutting off a man’s ear only to have Jesus rebuke him for the violent resistance. Jesus then heals the man’s ear, and peacefully surrenders (Luke 22:52). Peter’s efforts to use his own strength blind him, and while covertly waiting for his opportunity to rescue Jesus, he doesn’t even realize that he has begun to deny Jesus until he has done it three times. Peter breaks down weeping, crushed beneath his own efforts (Mark 14:72). If we could just live by faith in Christ rather than our own efforts, this pattern could be broken. As in 2 Corinthians 4:7-12, we could be “pressed on every side, but not crushed; perplexed but not in despair…” So that this treasure contained in flesh, “jars of clay” is revealed in us through our suffering. In verse 11 it even says, “For we who live are always being given over to death for Jesus’ sake, so that the life of Jesus also may be manifested in our mortal flesh.” When we love others as we are commanded, putting our full trust/faith in Christ, God will reveal this otherworldly, inhuman transformation to others through our suffering.

This is the transformation we see in the disciples in the book of Acts. As Peter and John stand before the Sanhedrin for proclaiming in Jesus the resurrection of the dead (the same group who had just arranged Jesus’ Crucifixion), in verse 13, the leaders are astonished at the bold and powerful stance of these “unschooled” men. A transformation had taken place. The same guys who ditched and denied Jesus had become leaders of a movement of people who would gladly die as martyrs for Christ. The key is that not one of them did this on their own strength, but only as they lived by faith in the Son of God, who loved them and gave himself up for them (paraphrased Gal 2:20b).

I’m out in my own practice now. I often reflect with sadness about the poor testimony that my self-reliant, weak Christianity gave to my coresidents and patients during residency. When faced with challenges that require giving sacrificially, I find freedom in trusting Christ. I remember a day when a patient of mine came in urgently because his foot wounds were becoming infected. He was a drug abuser, and I had already had to tell him “No” several times as he tried to get me to prescribe him narcotics. Now he was interrupting my schedule putting me behind and as I got the story and looked at his foot, I knew that this was going to take me a long time. Time, that would force me to make other patients wait to be seen, and likely make them unhappy with me. My patient had been attacked by a pit bull several weeks previously. The damage done to his foot required a very complex repair to the skin on the bottom of his foot and he had so many stitches I didn’t bother counting. The stitches had been put in by the local emergency department, and looking at his foot I could see that the suture lines were becoming infected. He hadn’t taken care of his wounds properly. His foot was covered in dirt and debris, and the skin was beginning to grow over the top of the stitches in many places. He had neglected to seek medical care and get his stitches out within the 10 days that he was originally instructed. I had the option to turn him away, to tell him to go back to the emergency department and have them deal with it. I already knew that his medicaid insurance wouldn’t even cover the cost of my overhead for seeing him. I felt the tug of the Holy Spirit, and I knew that I was supposed to help him anyway. At first I was very frustrated, as I began to wash the filth from his foot, but as I leaned into trusting God. I began to ask him what he thought about Jesus. While removing stitches from his foot, and dressing his wounds I was able to share with him a brief account of the gospel. I told my wife later that when I obeyed God, I went from being frustrated and overwhelmed by the situation to feeling like this world could not contain me. I was stirred with such a confidence in Jesus and in his love for me and for this man and his stinky foot, that I knew that nothing else really mattered.

I continued to follow up with him over the next year. He continued to struggle with substance addiction, and even told me that he was trusting in Christ for the forgiveness of his sins. Yet, his life never seemed to get free of the sins that entangled him. He was very frail, and prone to infection. Several months ago, he contracted a lung infection that took his life. While I am grieved by his life and deeply concerned for his soul, my hope for him remains unshakable, because it is not in him, or myself, or my successes. My hope is in Christ.

Therefore, since we are receiving a kingdom that cannot be shaken, let us be thankful, and so worship God acceptably with reverence and awe, for our “God is a consuming fire.” – Hebrews 12:28-29

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